I'm modeling ~18 months time-on-treatment for post-Criz, this poster shows 20 months for all ALK+ patients in P1/P2 trial, which includes non-responders. I'm holding 30 months for TKI-naive, hoping for something closer to 36. TOT is similar to PFS but varies in relation to ORR, deeper responses, and time-to-progression.
Just to illustrate the underestimated market for frontline with 2nd-gen agents the following compares peak annual sales based on TOT and an equal 25% market share. (~12,600 pts. worldwide, dev. country, adv. stage /4 = 3,150 pts. x $150,000 per year).
1L TKI PFS Avg. TOT Peak ($M)
Crizotinib 10m 10m $393
Ceritinib 18m 20m $787
Alectinib 22m 26m $1,021
Brigatinib 26m 30m $1,179
Total frontline in 2020 (w/ Criz only) $1,572
Total frontline in 2020 (w/ 2nd-gen) $3,380 |
